Surgical Bypass for Visceral Ischemic Syndrome

What is a surgical bypass for visceral ischemic syndrome?

A surgical bypass reroutes blood flow around a blocked blood vessel by creating a new pathway for blood flow using a graft.

Why is this procedure performed? Why do I need this procedure?

The goal of treatment is to re-direct the blood flow in the artery to bypass a blockage. You may need this procedure if your arteries become too narrowed or blocked from plaque inside the artery walls. If arteries are blocked, blood cannot get through to nourish the tissues of the bowel or gastrointestinal system (intestines).

Acute mesenteric ischemia is a life-threatening condition. In contrast, chronic mesenteric ischemia is characteristically associated with abdominal pain after meals. The onset of pain is usually gradual and progressive. Eventually, this situation results in substantial weight loss and a marked alteration in dietary intake.

Each patient is evaluated, and treatment will be individualized for the patient’s circumstances.

Where is the procedure performed and who performs this procedure?

This procedure is performed in the hospital surgical suite by a vascular surgeon.

What are the risks and potential complications of the procedure?

Your doctor will discuss the specific risks and potential benefits of the recommended procedure with you.

Bypass surgery usually has no complications, but there may be a risk of injury to the blood vessel. Another possible complication is the development of a hernia at the site of incision. In addition, the return of normal bowel function may be slow, and patients may not be able to eat for several days following the surgery. Your vascular surgeon will discuss the important risks and benefits with you.

Special precautions are taken to decrease these risks, and there may be other possible risks. When you meet with your doctor, please ask questions to make sure you understand the risks of the procedure and why the procedure is recommended.

How do I prepare for the procedure?

A few days before the procedure, pre-procedure tests may be performed to ensure that it is safe to perform the surgery. You may need to discontinue certain medications before the procedure. Your health care team will provide specific instructions to help you prepare for the procedure.

What happens during the procedure?

The surgical bypass will be performed under general anesthesia. To bypass the blockage, the surgeon makes a small opening just below the blockage in the diseased artery and places a graft, which is either a portion of one of your veins or a man-made synthetic tube. The surgeon will connect the graft above and below the blockage to allow blood around the blockage.

How long does the procedure last?

The procedure itself generally takes three to five hours, but the preparation and recovery time add several hours. The surgery may require a minimum hospital seven to 10 days.

What happens after the procedure?

Most patients require routine admission to an intensive care unit for close monitoring for about one to two days after the surgery. Once the patient is transferred to the nursing unit, the hospital stay is about three to seven more days. Most patients will receive physical therapy during the recovery period.

Your doctor will provide specific guidelines for your recovery.

Are there any side effects of the treatment?

As with any surgical procedure, you will feel somewhat tired for a few weeks. You will have mild pain along the incisions. Some patients will experience cramping and abdominal pain, and may have intermittent constipation and/or diarrhea for a few weeks.

What are typical results of the procedure?

Restoring blood flow by performing a surgical bypass usually provides good relief of symptoms. In addition to following a low-fat diet, eating small, frequent meals is recommended for patients with ischemia. Regular exercise, as well as managing blood pressure, cholesterol and diabetes, also are recommended.

How do I find out if I am a candidate for this procedure?

Your doctor will discuss the specific risks and potential benefits of the recommended procedure with you. A few days before the procedure, pre-procedure tests may be performed to ensure that it is safe to perform the surgery. You may need to discontinue certain medications before the procedure. Your healthcare team will provide specific instructions to help you prepare for the procedure. The surgical bypass will be performed under general anesthesia.

To bypass the blockage, the surgeon makes a small opening just below the blockage in the diseased artery and places a graft, which is either a portion of one of your veins or a man-made synthetic tube. The surgeon will connect the graft above and below the blockage to allow blood around the blockage. Most patients require routine admission to an intensive care unit for close monitoring for about one to two days after the surgery. Once the patient is transferred to the nursing unit, the hospital stay is about three to seven more days.

Most patients will receive physical therapy during the recovery period. As with any surgical procedure, you will feel somewhat tired for a few weeks. You will have mild pain along the incisions. Some patients will experience cramping and abdominal pain, and may have intermittent constipation and/or diarrhea for a few weeks.

To find out if you are a candidate for this procedure, please call the Vascular Surgery Department at 216.444.4508 or 800.223.2273 ext. 4-4508.